Iodine nutrition status and its association with microvascular complications in urban dwellers with type 2 diabetes

Chen, Chi; Chen, Yi; Zhai, Hualing; Xia, Fangzhen; Han, Bing; Wang, Yuying; Wan, Heng; Wang, Ningjian; Lu, Yingli

doi:10.1186/s12986-020-00493-5

Cited by 5 publications

(5 citation statements)

References 43 publications

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“…In our present study no correlation between thyroid hormones and DR was found, despite our stratification of DR. There is conflicting evidence regarding the association between DR and thyroid function (50)(51)(52), with some studies suggesting no significant association while others indicating a possible link. A decrease in thyroid hormone or SCH may increase the probability of DR, PDR, and diabetic macular edema (53)(54)(55).…”

Section: Discussionmentioning

confidence: 99%

Assessment of the association between genetic factors regulating thyroid function and microvascular complications in diabetes: A two-sample Mendelian randomization study in the European population

Li²,

Dong³

et al. 2023

Front. Endocrinol.

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BackgroundObservational studies have identified a possible link between thyroid function and diabetic microangiopathy, specifically in diabetic kidney disease (DKD) and diabetic retinopathy (DR). However, it is unclear whether this association reflects a causal relationship.ObjectiveTo assess the potential direct effect of thyroid characteristics on DKD and DR based on Mendelian randomization (MR).MethodsWe conducted an MR study using genetic variants as an instrument associated with thyroid function to examine the causal effects on DKD and DR. The study included the analysis of 4 exposure factors associated with thyroid hormone regulation and 5 outcomes. Genomewide significant variants were used as instruments for standardized freethyroxine (FT4) and thyroid-stimulating hormone (TSH) levels within the reference range, standardized free triiodothyronine (FT3):FT4 ratio, and standardized thyroid peroxidase antibody (TPOAB) levels. The primary outcomes were DKD and DR events, and secondary outcomes were estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (ACR) in diabetes, and proliferative diabetic retinopathy (PDR). Satisfying the 3 MR core assumptions, the inverse-variance weighted technique was used as the primary analysis, and sensitivity analysis was performed using MR-Egger, weighted median, and MR pleiotropy residual sum and outlier techniques.ResultsAll outcome and exposure instruments were selected from publicly available GWAS data conducted in European populations. In inverse-variance weighted random-effects MR, gene-based TSH with in the reference range was associated with DKD (OR 1.44; 95%CI 1.04, 2.41; P = 0.033) and eGFR (β: -0.031; 95%CI: -0.063, -0.001; P = 0.047). Gene-based increased FT3:FT4 ratio, decreased FT4 with in the reference range were associated with increased ACR with inverse-variance weighted random-effects β of 0.178 (95%CI: 0.004, 0.353; P = 0.046) and -0.078 (95%CI: -0.142, -0.014; P = 0.017), respectively, and robust to tests of horizontal pleiotropy. However, all thyroid hormone instruments were not associated with DR and PDR at the genetic level.ConclusionIn diabetic patients, an elevated TSH within the reference range was linked to a greater risk of DKD and decreased eGFR. Similarly, decreased FT4 and an increased FT3:FT4 ratio within the reference range were associated with increased ACR in diabetic patients. However, gene-based thyroid hormones were not associated with DR, indicating a possible pathway involving the thyroid-islet-renal axis. However, larger population studies are needed to further validate this conclusion.

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Section: Discussionmentioning

confidence: 99%

Assessment of the association between genetic factors regulating thyroid function and microvascular complications in diabetes: A two-sample Mendelian randomization study in the European population

Li²,

Dong³

et al. 2023

Front. Endocrinol.

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“…However, in a study conducted in Japan, this value was reported as 115.4 μg/L. [ 19 ] This study found that diabetic patients with low iodine levels had a higher likelihood of diabetic kidney disease. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 19 ] This study found that diabetic patients with low iodine levels had a higher likelihood of diabetic kidney disease. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Is there a relationship between the urinary iodine of pregnant and diabetic patients?

Öztürk

2023

Journal of Family Medicine and Primary Care

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Objectives: We investigated the iodine status in this study in pregnant women, diabetic women–men, and nondiabetic men–women living in our region. Methods: A total of 385 cases who applied to the endocrine clinic between 2015 and 2020 were reviewed retrospectively. The gender, age, free T3 (pg/ml), free T4 (ng/dl), TSH (μIU/mL), anti-TPO antibody (IU/ml), anti-thyroglobulin antibody (IU/ml), and random urine iodine concentration (μg/L) levels of cases were recorded. The cases were grouped as pregnant, female, male, diabetic female, and diabetic male. Cases with overt thyroid disease, heart failure, liver failure, and kidney failure were excluded. Results: There were 6.75% (n = 26) pregnant, 54.8% (n = 211) nondiabetic female patients, 18.9% (n = 73) diabetic female patients, 12.7% (n = 49) nondiabetic male, and 4.15% (n = 16) diabetic male patients. The random urinary iodine level was significantly higher in nondiabetic women (112.9 ± 77.21) and diabetic women (140.7 ± 97.8) than in pregnant women (77.8 ± 31.8) (P = 0.00 and P = 0.03). There was no significant relationship between random urine levels of pregnant women and nondiabetic men (104.1 ± 82.6) (P = 0.16). The random urinary iodine level was significantly higher in diabetic men (170.0 ± 112.1) than in pregnant women (P = 0.00). Conclusions: In our region (xxx Region), pregnant women had iodine deficiency. The iodine level in men and women was very close to the lower limit. The urinary iodine level was higher in diabetic women and diabetic men than in both pregnant women and nondiabetic women and nondiabetic men. The results brought us the question: Could the high spot urinary iodine level in diabetic patients be a clue to nephropathy?

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“…The information on sociodemographic characteristics, medical history, family history, and lifestyle factors was accessed by the same group of trained and experienced personnel from the SPECT-China study and the METAL study [ 25 – 27 ] through using a detailed questionnaire. Anthropometric measurements including weight, height, neck circumference (NC), waist circumference (WC), hip circumference (HC) and blood pressure are taken by trained staff following the standard protocol described earlier [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

High prevalence of metabolic diseases, liver steatosis and fibrosis among Chinese psychiatric patients

Chen

et al. 2023

BMC Psychiatry

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Background We aimed to investigate the differences of metabolic disorders between the general population and psychiatric patients, with an emphasis on the prevalence and influencing factors of liver fibrosis in psychiatric patients. Methods A total of 734 psychiatric patients and 734 general population matched for age, sex, and BMI were enrolled from Shanghai, China. All participants underwent blood pressure, glucose, lipid profile measurements, and anthropometric parameters including body weight, height and waist circumference. FibroScan examinations were also performed on psychiatric patients. Liver steatosis and fibrosis were diagnosed by controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) by professional staff. Results Compared with the general population, psychiatric patients revealed significantly higher burden of metabolic disorders. The overall prevalence of liver steatosis (CAP ≥ 233 dB/m) and fibrosis (LSM ≥ 7.0 kPa) was 48.7% and 15.5% in psychiatric patients. Psychiatric patients with liver steatosis or fibrosis showed worse metabolic profile. Meanwhile, the prevalence of liver fibrosis was also significantly higher in patients with overweight, central obesity, diabetes, hypertension, metabolic syndrome, and liver steatosis. In logistic regression analyses, age, BMI and visceral adiposity index were independent risk factors for liver fibrosis in psychiatric patients. Additionally, antipsychotic medication was suggested to be associated with an increased risk of liver fibrosis in psychiatric patients with liver steatosis. Conclusions Prevalence of liver steatosis and fibrosis is high in Chinese psychiatric patients. Those with antipsychotic polypharmacy and obesity are at high risk, and may benefit from early liver assessment in preventing fibrosis progression.

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Iodine nutrition status and its association with microvascular complications in urban dwellers with type 2 diabetes

Cited by 5 publications

References 43 publications

Assessment of the association between genetic factors regulating thyroid function and microvascular complications in diabetes: A two-sample Mendelian randomization study in the European population

Assessment of the association between genetic factors regulating thyroid function and microvascular complications in diabetes: A two-sample Mendelian randomization study in the European population

Is there a relationship between the urinary iodine of pregnant and diabetic patients?

High prevalence of metabolic diseases, liver steatosis and fibrosis among Chinese psychiatric patients

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